{"aaData": [["1", "UB-82", "", "", "", "", "
PRINTED FORM
\n", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["10000", "LOCAL HCFA 1500 (AUTO-ADDED)", "", "", "", "
BILL/CLAIMS
\n", "
PRINTED FORM
\n", "
66
\n", "
NO
\n", "
LEGACY HCFA-1500
\n", "
LOCAL HCFA 1500 (AUTO-ADDED)
\n", "", "", "", "", "", "", "", "", ""], ["10001", "LOCAL UB-92 (AUTO-ADDED)", "", "", "", "
BILL/CLAIMS
\n", "
PRINTED FORM
\n", "
66
\n", "
NO
\n", "
LEGACY UB-92
\n", "
LOCAL UB-92 (AUTO-ADDED)
\n", "", "", "", "", "", "", "", "", ""], ["12", "LEGACY HCFA-1500", "", "", "", "
BILL/CLAIMS
\n", "
PRINTED FORM
\n", "
66
\n", "", "", "
*LEGACY NATIONAL HCFA-1500
\n", "", "", "", "
D ENTPRE^IBCFP1
\n", "
D ENTPOST^IBCFP1
\n", "", "
D QB1^IBCFP1
\n", "
D FORMPRE^IBCFP1
\n", "
D FORMPOST^IBCFP1
\n"], ["13", "LEGACY UB-92", "", "", "", "
BILL/CLAIMS
\n", "
PRINTED FORM
\n", "
66
\n", "", "", "
*LEGACY NATIONAL UB-92
\n", "", "", "", "
D ENTPRE^IBCFP1
\n", "
D ENTPOST^IBCFP1
\n", "", "
D QB1^IBCFP1
\n", "
D FORMPRE^IBCFP1
\n", "
D FORMPOST^IBCFP1
\n"], ["2", "CMS-1500", "", "", "
EN^IBCF2
\n", "
BILL/CLAIMS
\n", "
PRINTED FORM
\n", "
66
\n", "
YES
\n", "", "
NATIONAL CMS-1500
\n", "", "
CMS-1500
\n", "", "
D ENTPRE^IBCFP1
\n", "
D ENTPOST^IBCFP1
\n", "", "
D QB1^IBCFP1
\n", "
D FORMPRE^IBCFP1
\n", "
D FORMPOST^IBCFP1
\n"], ["3", "UB-04", "", "", "
EN^IBCF3
\n", "
BILL/CLAIMS
\n", "
PRINTED FORM
\n", "
66
\n", "
YES
\n", "", "
NATIONAL UB-04
\n", "", "
UB-04
\n", "", "
D ENTPRE^IBCFP1
\n", "
D ENTPOST^IBCFP1
\n", "", "
D QB1^IBCFP1
\n", "
D FORMPRE^IBCFP1
\n", "
D FORMPOST^IBCFP1
\n"], ["4", "BILL ADDENDUM", "", "", "
EN^IBCF4
\n", "", "
PRINTED FORM
\n", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["5", "IB REPORTS", "", "", "", "", "
PRINTED FORM
\n", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["6", "MRA", "", "", "", "", "
PRINTED FORM
\n", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["7", "J430D", "", "", "", "
BILL/CLAIMS
\n", "
PRINTED FORM
\n", "", "
YES
\n", "", "
Dental Form
\n", "", "", "", "", "", "", "", "", ""], ["8", "IB 837 TRANSMISSION", "", "", "", "
BILL/CLAIMS
\n", "
TRANSMITTED FORM
\n", "", "
YES
\n", "", "
The national 837 EDI output
\n", "", "", "", "
D PRE^IBCE837A
\n", "
D POST^IBCE837A
\n", "
D OUTPUT^IBCE837
\n", "
D FIND^IBCE837
\n", "
D SETUP^IBCE837(0)
\n", "
D CLEANUP^IBCE837
\n"]]}